Schedule C

Name

First Name

Last Name

I certify that i incurred the following expenses and received the revenue for tax year

Total Revenue

Advertising

Bad Debts

Commissions Paid

Fees Paid

Depletion

Depreciation/Section 179

Insurance (other than health)

Mortgage Interest

Other Interest Payments

Licenses

Professional Services

Legal Services

Office Expense

Phones

Business Line

Cellular

Pager

Rent

Vehicle

Machinery

Equipment

Other Business Rent

Supplies

Taxes

Real Estate

Personal Property

Employee

Other

Travel

Meals/Entertainment

(enter total 50% deductable)

Wages

Pension and Profit Sharing

Cost Of Goods Sold

Beginning Inventory

Purchases

Personal Use Total

Other Cost

Ending Inventory

Equipment Purchased or Sold (list)

Car Expenses

Mileage

Business

Commuting

Other

Actual Expenses

Gas

Oil

Tires

Repairs

Tolls/Parking

TOTAL BUSINESS EXPENSE

Tax Payer Social Security Number

Todays Date

YYYY

Harn Financial Group will prepare your 2017 tax return from the information you have provided, we will not audit or verify the information you have furnished to us, you the taxpayer , are ultimately responsible for the preparation and filing of your tax return . I, the taxpayer named above, have provided to Harn Financial Group the attached tax information and to the best of my knowledge this information is true, correct, and complete

AGREE